Hearing and Literacy: Trends in Georgia Children. N Wendell Todd Comer Yates

Transcription

1 Hearing and Literacy: Trends in Georgia Children N Wendell Todd Comer Yates

2 Disclaimer: The opinions I am about to express are my own. They do not necessarily represent the opinions of Emory University, its trustees, president, provost, deans, schools, divisions, sections, faculty, staff, alumni, donors, students, groundskeepers, or trespassers. slide courtesy of Arthur L Kellermann, MD, MPH

3 Why am I talking about this? For the 2009 meeting of the Society for Ear Nose and Throat Advances in Children, I was tasked with an hour presentation: How so we attend poor children? Since preparing that presentation, concerns about literacy have increased.

4 Why me? Track record of attending the poor: e.g., 10 years Indian Health Service Grew up in Mississippi At the 2006 SENTAC in Toronto, presented data that non-follow-up from newborn hearing screening is problematic system, not problematic poor mothers I have trouble saying no. My priority list of what children need: Love Sanitation Security Justice Trustworthiness Food Literacy Education Money

5 Be literate by third grade Until third grade, a child learns to read. After third grade, a child reads to learn. Number of future jail cells needed = number of children failing third grade reading tests. In California, North Carolina, Texas, and Virginia, the failure rate on third grade reading tests is now used to help project the number of jail cells that will be needed when those third graders are adults. Annie E Casey Foundation

6 Objectives Review relationship of hearing and literacy Review data of hearing impairment in Georgia children, and what is being done Review data of literacy in Georgia children, and what is being done

7 Tautologies Hearing is important for language and communicative development, including literacy Literacy is necessary for survival, and learning and thriving

8 Identifying Hearing Impairment in Georgia Children Since August 2000, newborns have physiologic auditory screening: A-OAE or A-ABR State law requires hearing screening at 25dBHL for all children entering public school for first time (but, no data about number of children who do not pass)

9 Automated Auditory Brainstem Response Sounds are presented. Surface electrodes measure brainstem activity.

10 Otoacoustic Emissions Sounds are presented to the ear canal. A microphone measures the response in the ear canal.

11 Occurrence of Hearing Loss 3 per 1000 infants are born with a permanent sensorineural hearing loss (~1 Georgia baby/day) 1/1000 from the well baby nursery 10/1000 from the NICU Rate increases to approximately 6/1000 by school age slide from Krista Biernath & John Eichwald, CDC EHDI

12 3 lines of evidence that hearing in Georgia children is being addressed 1) CDC assemblage of newborn screening data, More than 99% screened 2) National Health and Nutrition Examination Survey (NHANES) versus ) Survey about children disabled by hearing loss,

13 CDC MMWR, March 5, 2010

14 Territories of the Unites States District of Columbia American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Puerto Rico Republic of Palau Virgin Islands

15 Percent of did not pass hearing screen 60 Newborn Auditory Screening Trends: Georgia versus Total, GA U.S. Hearing Loss Normal LFU/LTD U.S. Lost to Follow-Up / Lost To Documentation

16 CDC assemblage of 2009 data

17 CDC assemblage of 2010 data

18 CDC assemblage of 2011 data

19 National Health and Nutrition Examination Survey (NHANES) versus Nationally representative cross-sectional data Normal: <= 15dBHL for kHz Mild (or worse hearing loss) if >=25dBHL Any hearing loss worsened: 14.9% (95%CI ) to 19.5% (95%CI ) Unilateral high frequency loss worsened: 12.8% (95%CI ) to 16.4% (95%CI ) Noise-induced hearing loss suspected Shargorodsky et al., JAMA, 2010

20 Children Disabled by Hearing Loss, Family Reported

21 Relationship of hearing & reading Historically, d/deaf and hard of hearing students read at late 3 rd to early 4 th grade level Surveyed a convenience sample 7 states educators in charge of d/deaf & hard of hearing students Easterbrooks & Beal-Alvarez, 2012

22 Easterbrooks & Beal-Alvarez (2012) had problems with their study Data from only 7 of 50 states No clear definition of degrees of hearing loss Assessment measures differed from state to state Definitions of reading proficiency differed from state to state

23 from Easterbrooks & Beal-Alvarez, 2012

24 Easterbrooks & Beal-Alvarez (2012) nevertheless tentatively concluded: No better study of reading in d/deaf and hard of hearing students is available Most of the 7 states reported somewhat better reading than predicted by glass ceiling A common core of standards may allow for more rigorous study

25 Literacy in Georgia children: Why? What to do? Comer Yates

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